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Transgender sex offenders are a small, complex and atypical group. The purpose of this paper is to highlight the issues in relationship to the assessment of gender dysphoria in transgender sex offenders and approaches to risk management.

Clinical and research experience as a Gender Specialist and Consultant Forensic Psychiatrist who has managed sex offender populations has informed this publication.

Little is known about the relationship between gender dysphoria and criminality. More research is required to develop a typology of transgender sex offenders and develop actuarial risk instruments. Protective factors in relation to gender affirmative care are also important to understand.

There is little empirical research to guide gender specialists and criminal justice professionals in the management of gender dysphoria and address risk and recidivism in transgender offender populations. The treatment of gender dysphoria could result in improved well-being and better psychosocial adjustment but cannot be relied to reduce future recidivism.

There is no evidence that treatment of gender dysphoria reduces risk and recidivism in transgender sex offenders and that research is required to identify specific gender related dynamic risk factors.

Recommendations are directly relevant to the work of prison and probation staff, community supervisors and gender identity specialists.

As far as the author is aware it is the first paper on the assessment and management of gender diverse sex offenders integrating approaches to gender dysphoria assessment and treatment and risk management. It has implication for gender identity specialists, criminal justice professionals, research and policy.

This study aims to increase the understanding of the early-stage identity-related information needs of transgender people.

This study draws on social constructivism, queer theory and information practice research. In accordance with the queer phenomenological approach which emphasises lived experiences, data was collected by interviewing 25 individuals who identified as transgender. The data was analysed with a focus on how early-stage information needs are formed into conscious information needs.

The formation of early-stage information needs were conceptualised as a chain including a trigger for information seeking, finding the right words and understanding the experience. Especially the bodily changes starting at puberty were strong causes of discomfort causing friction between the subjects' own gendered body and their gender experience, even leading to gender dysphoria. Finding words to describe the experience played an important role in the process of identity formation. In many cases this was difficult because of the lack of accurate and relevant information.

Providing information especially of varying transgender experiences is vital for individuals trying to understand and verbalise their gender identity.

This study provides an understanding of the early-stage information needs described by transgender people and the process of building identities through disorientation. This study suggests that early-stage information needs are a valid concept to help understand how embodied experiences and the friction between the lived experience and the social world can lead to information seeking.

The purpose of this paper is to present findings from the Trans Mental Health Study (McNeil et al., 2012) – the largest survey of the UK trans population to date and the first to explore trans mental health and well-being within a UK context. Findings around suicidal ideation and suicide attempt are presented and the impact of gender dysphoria, minority stress and medical delay, in particular, are highlighted.

This represents a narrative analysis of qualitative sections of a survey that utilised both open and closed questions. The study drew on a non-random sample (n=889), obtained via a range of UK-based support organisations and services.

The study revealed high rates of suicidal ideation (84 per cent lifetime prevalence) and attempted suicide (48 per cent lifetime prevalence) within this sample. A supportive environment for social transition and timely access to gender reassignment, for those who required it, emerged as key protective factors. Subsequently, gender dysphoria, confusion/denial about gender, fears around transitioning, gender reassignment treatment delays and refusals, and social stigma increased suicide risk within this sample.

Due to the limitations of undertaking research with this population, the research is not demographically representative.

The study found that trans people are most at risk prior to social and/or medical transition and that, in many cases, trans people who require access to hormones and surgery can be left unsupported for dangerously long periods of time. The paper highlights the devastating impact that delaying or denying gender reassignment treatment can have and urges commissioners and practitioners to prioritise timely intervention and support.

The first exploration of suicidal ideation and suicide attempt within the UK trans population revealing key findings pertaining to social and medical transition, crucial for policy makers, commissioners and practitioners working across gender identity services, mental health services and suicide prevention.

The case of a woman with a history of offending and prolonged imprisonment is given. The purpose of this paper is to explore the complex interplay between diagnoses of autistic spectrum disorder (ASD), personality disorder and gender dysphoria. A discussion on useful and less useful treatment approaches follows, given the unusual and complex clinical presentation.

This is a case report with a summary of the background to this under-researched area.

The way in which the diagnostic picture clarified over time is explained. The difficulties in accurately diagnosing are put forward and strategies to address this are suggested. Successful treatment of unusual clinical problems may require highly individualised care within generic services.

The authors know of no similar case reports in the published literature. The clinical associations between ASDs, personality disorders and gender dysphoria, in forensic mental health populations, appears to be unexplored in the literature.

The purpose of this paper is to systematically review the literature on gender identity disorder (GID) and associated gender disorders in people with learning disabilities and autism, specifically focusing on aetiology, treatment and management.

This study reviewed all the published papers about individuals with both a learning disability and/or autistic spectrum disorder and a gender disorder. Papers from 1980 onwards were included as this was the year of the introduction of GID to the ICD-10. Gender disorders were taken to include the following: GID, transsexualism, cross-dressing, transvestitism or a gender-related sexual disorder.

In total, 16 papers described 43 individuals meeting the inclusion criteria. There was a dearth of guidance on appropriate treatment or management.

Only English language papers were searched. This review points towards more research needed in this area.

In collating relevant papers the review begins the search for evidence regarding aetiology, treatment and management of gender disorders in an area where evidence-based guidelines are needed.

Gender identity assessments (GIAs) have been criticized by practitioners and trans and gender non-conforming (TGNC) individuals alike. With the practice of exploring individuals’ gender identity for treatment pathway purposes being potentially invasive and inappropriate, the current study aims to explore explicit standards.

The current study used the Delphi methodology to survey practitioners familiar with GIA. Over three rounds, 14 international participants rated their agreement about six areas relating to the assessment: purpose; content; approach; forensic application; psychometric instruments; and wider issues. Statements that reached an 80% cut-off among participants were viewed as a sufficient level of agreement, while the remaining items were fed back for repeated ratings. Furthermore, participants had the opportunity to suggest additional items that the group could rate.

Overall, a consensus across 23 items was achieved. The findings indicate a practice emphasizing collaboration between clinician and client to facilitate an informed decision. Furthermore, participants advocated for a non-pathologizing version of the GIA. This is a departure from diagnoses like gender dysphoria toward an approach which encapsulates also positive aspects of the trans experience, for example, resilience and future plans.

Limitations include sampling biases due to participants’ high specialization and challenges in recruiting TGNC individuals. Furthermore, findings appear restricted to adult services.

To the best of the author’s knowledge, this pilot is a first step to making current practice transparent and comparable, with the hopes to improve trans care. Furthermore, it is contextualized with the previously suggested application of the power threat meaning framework to GIA.

The purpose of this paper is to briefly address three interrelated areas of concerns – victimization, housing placement and healthcare provision – related to the health and welfare of transgender women in jails, prisons and other types of detention facilities.

Drawing on a growing body of research on health risks for transgender women who are detained in facilities in California and elsewhere, the authors provide recommendations for policy and practice that constitutes gender-affirming healthcare for transgender women behind bars.

Policymakers, correctional leaders, and prison-based clinicians have a number of opportunities to address the welfare of transgender women in jails, prisons and other types of detention facilities.

This policy brief offers concrete steps government officials can take to better meet their professional and constitutional obligations, provide higher quality care for transgender women involved in the criminal justice system, and effectuate positive changes in transgender women’s health and welfare both inside and outside of carceral environments.

Through the media it is clear that the number of people who are openly identifying as transgender is growing. Some of those people who are identified as transgender are adults but many times they are younger and sometimes young children (under the age of eight). As young children are sharing with family and school personnel that their gender and the assigned gender at birth are not an exact match, families and school personnel need the tools to support these children. Since most teacher training programs do not currently have preparation in working with children who are transgender or gender fluid, it is up to teachers and administrators to seek out materials and resources until such time as teacher preparation programs include this in the curriculum. In this chapter, the author shares basic terminology, ideas about changing curriculum, language, and environment in early childhood settings to help welcome young children who are transgender or gender fluid into these spaces. In addition, possible questions children and adults may ask are included along with resources and books about people who are transgender that are age appropriate for early childhood settings.

Anyone who has recently watched television or movies can tell you that transgender, gender nonbinary or gender expansive people are becoming more visible in these media. This trend reflects the reality that younger generations are increasingly identifying with more fluid and nonbinary gender and sexual identities and are progressively expressing those identities in a more flexible and changing manner (Herman et al., 2022; Wilson & Meyer, 2021). Unsurprisingly then, those individuals are also more visible at work, including in workplaces with employer-mandated dress codes. Indeed, in 2020 the US Supreme Court decided a case involving a transgender woman, Aimee Stephens, who was fired because her employer, a funeral home, required her to conform to its gender-binary dress policy and wear clothing mandatory for people assigned male at birth, rather than appropriate for her female gender identity ( Bostock v. Clayton County, 2020).

However, as the description of Aimee Stephens's own experience illustrates, often these employer appearance codes are based on a binary and fixed conception of gender and gender identity and expression at odds with the increasing number of workers who do not identify within those rigid parameters. Moreover, even when an employee, like Aimee Stephens herself, could have fit within her employer's dress code, the improper application of that policy to her, or employer concerns about customer or co-worker discomfort with an employee's appearance under the policy may mean that a worker's identity and expression may still conflict with a workplace appearance code. For gender nonbinary or nonconforming individuals, these complications are magnified.

This chapter explores the practical problems and barriers that employer dress codes have on employees whose gender identity and/or presentation move beyond the traditional male/female binary. Using insights from queer theory, gender expansive employees serve to interrogate fundamental assumptions behind workplace dress policies and the formal and informal ways in which these policies are policed. The chapter will explore that discordance, examine possible employer resolutions, and evaluate the strengths and weaknesses of those responses.